Harry Richard Black, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

119574 Issued in NY

Practice address

659 W Onondaga St
Syracuse, NY 13204

Phone

(315) 475-5176

Fax

(315) 476-0263

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124124268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13204",
            "telephone_number": "315-475-5176",
            "fax_number": "315-476-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13204",
            "telephone_number": "315-475-5176",
            "fax_number": "315-476-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "HARRY",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "119574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHT",
            "identifier": "0018612",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "286833",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00981",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "321287",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Bittel, LMSW
• Jaclyn Blaauboer, MD
• Lisa Blachford, RN
• Cara Kay Black, OTR
• Gerald A Black, MD
• Karen Black, RN
• Patricia Black, R.N.
• Reana T Black
• Robert M Black, MD
• Tavia Black, PRS

• General Practice Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.